Advance care planning: The patient perspective.

Area of Science:

• Nephrology
• Palliative Care
• Bioethics

Background:

• Advance directives are crucial for honoring patient healthcare wishes.
• Many dialysis patients (only ~50%) lack advance directives.
• Fewer than 10% of dialysis patients discuss end-of-life care with physicians.

Purpose of the Study:

• To explore the experiences of dialysis patients in completing advance directives.
• To identify barriers and facilitators to advance directive completion in this population.
• To gather patient recommendations for improving advance directive uptake.

Main Methods:

• Qualitative interviews were conducted with dialysis patients.
• The Coalition for Supportive Care of Kidney Patients facilitated the interviews.
• Thematic analysis was used to identify key themes from patient experiences.

Main Results:

• Key themes included experiencing a health crisis, making decisions for others, and information availability.
• Patients shared practical recommendations and best practices for completion.
• The Coalition identified resources to aid in advance directive completion.

Conclusions:

• Understanding patient experiences is vital for improving advance directive completion rates.
• Targeted interventions and accessible information can support shared decision-making for end-of-life care.
• Facilitating these discussions and document completion is essential for patient-centered kidney care.